1
|
Craig JP, Barsam A, Chen C, Chukwuemeka O, Ghorbani-Mojarrad N, Kretz F, Michaud L, Moore J, Pelosini L, Turnbull AMJ, Vincent SJ, Wang MTM, Ziaei M, Wolffsohn JS. BCLA CLEAR Presbyopia: Management with corneal techniques. Cont Lens Anterior Eye 2024:102190. [PMID: 38851946 DOI: 10.1016/j.clae.2024.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report provides an overview of the evidence for the treatment profile, safety, and efficacy of the range of corneal techniques currently available for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. Presbyopia correction by conductive keratoplasty involves application of radiofrequency energy to the mid-peripheral corneal stroma which leads to mid-peripheral corneal shrinkage, inducing central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery.
Collapse
Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK.
| | | | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung City, Taiwan
| | - Obinwanne Chukwuemeka
- Cornea, Contact Lens and Myopia Management Unit, De-Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | | | | | | | - Andrew M J Turnbull
- Royal Bournemouth Hospital, University Hospitals Dorset, UK; Faculty of Life and Health Sciences, Ulster University, UK
| | - Stephen J Vincent
- Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - James S Wolffsohn
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK
| |
Collapse
|
2
|
Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
Collapse
Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| |
Collapse
|
3
|
Chen H, Mao X, Xu D, Guo C, Dai J. The dynamic changes and influencing factors of visual symptoms after small incision lenticule extraction. BMC Ophthalmol 2023; 23:223. [PMID: 37208645 DOI: 10.1186/s12886-023-02964-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND To investigate the dynamic changes and influencing factors of visual symptoms after small incision lenticule extraction (SMILE). METHODS This was a prospective observational study. Visual symptoms including glare, haloes, starbursts, hazy vision, fluctuation, blurred vision, double vision and focusing difficulties were evaluated before and 1, 3, 6 months after SMILE using a questionnaire. Generalized linear mixed models were used to assess the effects of preoperative characteristics and objective visual quality parameters on postoperative visual symptoms. RESULTS 73 patients/146 eyes were enrolled. Preoperatively, the most common symptoms were glare (55% of eyes), haloes (48%), starbursts (44%) and blurred vision (37%). At 1 month postoperatively, the incidence and extent scores of glare, haloes, hazy vision and fluctuation rose significantly. At 3 months, the incidence and extent scores of glare, haloes and hazy vision restored to baseline. And at 6 months, the extent scores of fluctuation returned to baseline. Other symptoms (e.g., starbursts) did not change before and 1, 3, 6 months after SMILE. Preoperative visual symptoms were associated with postoperative symptoms, as patients with a symptom preoperatively had higher postoperative scores for that symptom. Age was related to postoperative extent of double vision (coefficient = 0.12, P = 0.046). There were no significant associations between postoperative visual symptoms and preoperative SE, scotopic pupil size, angle kappa (with intraoperative adjustment), postoperative HOAs or scattering indexes. CONCLUSIONS The incidence and extent scores of hazy vision, glare, haloes and fluctuation increased at the first month after SMILE, and recovered to baseline at 3 or 6 months. Preoperative visual symptoms were associated with the postoperative symptoms and should be fully considered before SMILE.
Collapse
Affiliation(s)
- Han Chen
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, Fujian, China
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiuyu Mao
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, No.180 Fenglin Road, Shanghai, 200032, China
| | - Dongye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Chenwen Guo
- Department of Ophthalmology, Zhongshan Hospital of Fudan University (Xiamen Branch), Xiamen, Fujian, China
| | - Jinhui Dai
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, No.180 Fenglin Road, Shanghai, 200032, China.
| |
Collapse
|
4
|
Fernández J, Molina-Martín A, Rocha-de-Lossada C, Rodríguez-Vallejo M, Piñero DP. Clinical outcomes of presbyopia correction with the latest techniques of presbyLASIK: a systematic review. Eye (Lond) 2023; 37:587-596. [PMID: 35864161 PMCID: PMC9998429 DOI: 10.1038/s41433-022-02175-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to collect the scientific literature on the correction of presbyopia with laser in situ keratomileusis (presbyLASIK) in last years and to analyse the quality of such scientific evidence using a validated methodology for conducting a systematic review. A total of 42 articles were initially identified, but after applying the selection criteria and an additional manual search a total of 23 articles were finally included: 2 non-randomized controlled clinical trials (NRCT) and 21 case series. Quality assessment of NRCTs and case series was performed with the ROBINS-I and the 20-criterion quality appraisal checklist defined by Moga et al. (IHE Publ 2012), respectively. For NRCT, the risk of bias was moderate in one study and serious in the other NRCT, being the main sources of risk, the domains related to confounding, selection of participants and measurement of outcomes. For case series studies, the main source of risk of bias was subjects not entering the study at the same point of the conditions (different levels of presbyopia). Likewise, a significant level of uncertainty was detected for the following items: consecutive recruitment of patients, blinding of outcome assessors to the intervention that the patient received, and conclusions of the study not supported by the results. Research on presbyLASIK to this date is mainly focused on case series generating a limited level of scientific evidence. The two NRCTs identified only demonstrated the potential benefit of combining the multiaspheric profile with some level of monovision in the non-dominant eye.
Collapse
Affiliation(s)
- Joaquin Fernández
- Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain
| | - Ainhoa Molina-Martín
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Carlos Rocha-de-Lossada
- Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain
- Department of Ophthalmology, Hospital Virgen de las Nieves, Granada, Spain
- Department of Surgery, Area of Ophthalmology, University of Seville, Seville, Spain
| | | | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.
- Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain.
| |
Collapse
|
5
|
Ryu S, Jun I, Kang DSY, Arba-Mosquera S, Kim H, Jean SK, Seo KY, Kim EK, Kim TI. Presbyopia correction using the monocular bi-aspheric ablation profile in myopic eyes. J Cataract Refract Surg 2023; 49:69-75. [PMID: 36026693 DOI: 10.1097/j.jcrs.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/02/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To analyze the 6-month outcomes of the treatment combination of the monocular bi-aspheric ablation profile (PresbyMAX) and contralateral aspheric monofocal laser in situ keratomileusis (LASIK) ablation profile for correction of myopia and presbyopia. SETTING Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea. DESIGN Retrospective case series. METHODS This was a retrospective case review of 92 patients (184 eyes) diagnosed with myopia who underwent uneventful simultaneous bi-aspheric ablation in the nondominant eye and aspheric monofocal regular LASIK in the dominant eye to correct myopia and presbyopia between January 2017 and August 2020. Monocular and binocular uncorrected distance visual acuity (UDVA) and near visual acuity (UNVA), and corrected distance visual acuity and near visual acuity were analyzed postoperatively. RESULTS At 6 months postoperatively, the mean UDVAs (logMAR) in the dominant and nondominant eyes were 0.01 ± 0.02 and 0.26 ± 0.15, respectively. Furthermore, all treated dominant eyes achieved 20/20 or better monocular UDVA, and 84% achieved 20/16 or better monocular UDVA. In the nondominant treated eyes, 89% achieved 20/50 or better monocular UDVA, 78% achieved 20/40 or better, and 34% achieved 20/32 or better. The binocular cumulative UDVA at 6 months postoperatively was 20/20 or better in all patients. All patients achieved J2 or better in binocular cumulative UNVA, and 83% achieved J1. CONCLUSIONS Presbyopia correction using the combination of PresbyMAX in the near eye and aspheric monofocal regular LASIK in the distant eye is a safe and effective treatment for presbyopia in patients with myopia.
Collapse
Affiliation(s)
- Soyoung Ryu
- From the The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea (Ryu, Jun, H. Kim, Seo, T. Kim); Corneal Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea (Jun, Seo, E.K. Kim, T. Kim); Eyereum Eye Clinic, Seoul, South Korea (Kang, Jean); Biomedical Engineering Office, Research and Development, Schwind eye-tech-solutions GmbH & Co. KG, Kleinostheim, Germany (Arba-Mosquera); Saevit Eye Hospital, Goyang-Si, Gyeonggi-Do, South Korea (E.K. Kim)
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Ting DSJ, Liu YC, Price ER, Swartz TS, Lwin NC, Hipsley A, Mehta JS. Improvement in Accommodation and Dynamic Range of Focus After Laser Scleral Microporation: A Potential Treatment for Presbyopia. Transl Vis Sci Technol 2022; 11:2. [DOI: 10.1167/tvst.11.12.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Darren S. J. Ting
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
- Singapore Eye Research Institute, Singapore
| | - Yu-Chi Liu
- Singapore Eye Research Institute, Singapore
- Singapore National Eye Centre, Singapore
- Duke–NUS Graduate Medical School, Singapore
| | | | | | | | | | - Jodhbir S. Mehta
- Singapore Eye Research Institute, Singapore
- Singapore National Eye Centre, Singapore
- Duke–NUS Graduate Medical School, Singapore
| |
Collapse
|
7
|
Agarwal S, Thornell E. Early Outcomes of Two Treatment Modes of PresbyLASIK: Monocular vs. Micro-Monovision. Clin Ophthalmol 2022; 16:3597-3606. [PMID: 36345532 PMCID: PMC9636881 DOI: 10.2147/opth.s384553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/19/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To report the visual, refractive and subjective outcomes of presbyLASIK for the correction of presbyopia. METHODS Monocular (20 eyes) or micro-monovision (12 eyes) presbyLASIK was performed on a total of 32 eyes in 16 patients (50% female, average age 55±4.6 years) using the Zeiss VisuMax 400Hz femtosecond and Schwind Amaris 1050RS excimer laser platform. Predictability, safety and efficacy were assessed and compared at 4-6 weeks, 3 months and 6 months. Results were considered significant if P < 0.05. RESULTS For monocular treatments, average postoperative spherical equivalent (SE) was 0.1±0.1 D and -0.86±0.5 D at 4-6 weeks postoperatively for distance and near eyes respectively; 90% eyes achieved SE ±1.0 D of the target. Postoperative binocular uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) were -0.03±0.1 LogMAR (20/20), 0.09±0.26 LogMAR (N4) and 0.29±0.11 LogMAR (N6) respectively with 90% patients achieving binocular UDVA of 20/20 or better. For micro-monovision treatments, average postoperative SE was -0.33±0.51 D and -1.60±0.78 D at 4-6 weeks postoperatively for distance and near eyes respectively; 100% eyes achieved SE ±1.0 D of the target. Postoperative binocular UDVA, UIVA and UNVA were 0.05±0.16 LogMAR (20/20), -0.02±0.10 LogMAR (N3) and 0.23±0.08 LogMAR (N5) respectively with 67% patients achieving binocular UDVA of 20/20 or better. CONCLUSION Monocular and micro-monovision presbyLASIK are both effective options for the treatment of presbyopia. Monocular treatments are more likely to be well tolerated by patients who prefer to preserve exceptional distance vision, while micro-monovision treatments may be better suited to patients who can tolerate compromises in distance vision in order to attain greater intermediate vision function.
Collapse
Affiliation(s)
- Smita Agarwal
- Wollongong Eye Specialists, Wollongong, Australia,Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Erin Thornell
- Wollongong Eye Specialists, Wollongong, Australia,Correspondence: Erin Thornell, Tel +61 2 4223 6388, Fax +61 2 4263 0511, Email
| |
Collapse
|
8
|
Arba Mosquera S. Visual acuity and blur: An extended depth-of-focus model. Eur J Ophthalmol 2022; 33:11206721221123883. [PMID: 36200136 DOI: 10.1177/11206721221123883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This article proposes a simple model that describes the quantitative relationship between visual acuity and defocus (as in defocus curves) in the presence of higher-order aberrations (HOA). METHODS The basis model for describing the relationship between visual acuity and blur was taken from Blendowske as a starting point to develop an extended model applicable to defocus curves. The basis of Blendowskes's data is extended by incorporating effects induced by HOA. Aberrometric refractive errors are transformed into a single blur quantity b, also termed dioptric distance, which serves as an input in both models. The possible influence of the axes of asymmetric aberrations and the pupil size is not included. RESULTS The extended model has been used to generate reference data for a bi-aspheric multifocal correction profile for presbyopia. It provides reference data similar to what has been reported in the literature for that particular profile. CONCLUSIONS The model proposed in this article can be used to determine depth-of-focus effects associated with the presence of HOA. The extended model seems to provide a valid description for defocus curves. Actual uncertainties in experimental data on unaided visual acuity, especially the frequent lack of information on pupil diameter, prevent meaningful numerical comparison and the refinement of both models. However, theoretical arguments are provided in support of the extended model.
Collapse
|
9
|
Sun L, Jhanji V, Li S, Li J, Ji R, Zeng H, Ng TK, Zhang M, Zhang R. Vector analysis of astigmatic correction after single-step transepithelial photorefractive keratectomy and femtosecond-assisted laser in-situ keratomileusis for low to moderate myopic astigmatism. Indian J Ophthalmol 2022; 70:3483-3489. [PMID: 36190031 PMCID: PMC9789874 DOI: 10.4103/ijo.ijo_649_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose This study aimed to evaluate the outcomes of astigmatic correction by single-step transepithelial photorefractive keratectomy (TransPRK) and femtosecond-assisted laser in-situ keratomileusis (Femto-LASIK) surgeries. Methods A total of 218 subjects received TransPRK or Femto-LASIK surgery for the treatment of myopia and astigmatism (-2.25 to -0.25 D). Refraction errors and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were examined before and at 3 months after surgery. Astigmatism changes were assessed by vector analysis. Results Preoperative parameters of the TransPRK group were similar to the Femto-LASIK group. UDVA and CDVA at 3 months were similar between both groups. Manifest refraction (MR) spherical equivalent in the TransPRK group (0 ± 0.20 D) was slightly lower compared with the Femto-LASIK group at 3 months (0.11 ± 0.25 D, P = 0.001). MR cylinder was -0.06 ± 0.19 D in the TransPRK group and -0.02 ± 0.15 D in the Femto-LASIK group at 3 months (P = 0.135). The index of success (IS) was 0.15 ± 0.36 in the TransPRK group and 0.06 ± 0.17 in the Femto-LASIK group (P = 0.125). The correction index (CI) was 1.03 ± 0.19 in the TransPRK group and 1.01 ± 0.11 in the Femto-LASIK group (P = 0.815). Conclusion For low to moderate myopic astigmatism, TransPRK provided a comparable astigmatic treatment effect as Femto-LASIK. Myopic astigmatism was both slightly overcorrected after TransPRK and Femto-LASIK surgeries.
Collapse
Affiliation(s)
- Lixia Sun
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Vishal Jhanji
- UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Senmao Li
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Jinyu Li
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Ruifeng Ji
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Hongqiang Zeng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China,Correspondence to: Dr. Mingzhi Zhang, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hongkong, Dong Xia North Road, Shantou, Guangdong Province, China. E-mail:
Dr. Riping Zhang, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hongkong, Dong Xia North Road, Shantou, Guangdong Province, China. E-mail:
| | - Riping Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, China,Correspondence to: Dr. Mingzhi Zhang, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hongkong, Dong Xia North Road, Shantou, Guangdong Province, China. E-mail:
Dr. Riping Zhang, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hongkong, Dong Xia North Road, Shantou, Guangdong Province, China. E-mail:
| |
Collapse
|
10
|
Reinstein DZ, Archer TJ, Vida RS, Carp GI, Reinstein JFR, McAlinden C. Objective and Subjective Quality of Vision After SMILE for High Myopia and Astigmatism. J Refract Surg 2022; 38:404-413. [PMID: 35858192 DOI: 10.3928/1081597x-20220516-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report subjective and objective quality of vision (QoV) results for high myopic small incision lenticule extraction (SMILE) between -9.00 and -13.00 diopters (D). METHODS This was a prospective study recruiting 114 patients undergoing SMILE with attempted spherical equivalent refraction (SEQ) correction from -9.00 to -13.00 D, and cylinder up to 5.00 D. Patients were informed before surgery of the increased risk of QoV symptoms. Patients completed the Rasch validated QoV questionnaire. Objective QoV was assessed by corneal and whole eye aberrations, HD Analyzer Objective Scatter Index (OSI) (Keeler), and contrast sensitivity. Patient satisfaction was assessed on a scale from 0 (very dissatisfied) to 10 (very satisfied). Individual item and total Rasch-scaled scores for the three subscales (frequency, severity, and bothersomeness) of the QoV questionnaire were calculated before and 12 months after surgery. RESULTS The mean patient satisfaction score was 9.27 ± 1.18 (range: 2 to 10), 8 or higher in 93%, and 7 or higher in 98% of patients. One patient with a satisfaction score of 2 had a simple refractive error re-treatment and then reported a satisfaction score of 10. The total mean ± standard deviation Rasch-scaled QoV score for the frequency, severity, and bothersomeness subscales before surgery was 24 ± 19, 20 ± 16, and 19 ± 18, respectively. Scores increased after surgery to 41 ± 18, 32 ± 16, and 30 ± 21, respectively (P < .001). Corneal aberrations (6 mm, OSI) increased on average by 0.39 µm for spherical aberration, 0.41 µm for coma, and 0.56 µm for higher order aberrations root mean square. OSI increased on average by 0.58. There was a small but statistically significant improvement in contrast sensitivity at 3, 6, 12, and 18 cycles per degree. There were no statistically significant correlations found between subjective scores for starbursts and objective measurements. CONCLUSIONS Satisfaction was high following SMILE for high myopia. As expected, there was an increase in QoV symptoms, mainly glare and starbursts. The acceptance of QoV symptoms for high myopic SMILE was high, indicating that residual refractive error and visual acuity are the major drivers for patient satisfaction with appropriate preoperative informed consent. [J Refract Surg. 2022;38(7):404-413.].
Collapse
|
11
|
Fernández J, Rodríguez-Vallejo M, Burguera N, Rocha-de-Lossada C, Piñero DP. Spherical aberration for expanding depth of focus. J Cataract Refract Surg 2021; 47:1587-1595. [PMID: 34128496 DOI: 10.1097/j.jcrs.0000000000000713] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/05/2021] [Indexed: 11/26/2022]
Abstract
The increase in the depth of focus (DoF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons who have seen how new surgical possibilities to achieve DoF enlargement have emerged. Nowadays, several technologies to extend the DoF are available, from corneal laser refractive surgery procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspheric profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and, therefore, extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DoF, especially considering that SA depends on pupil diameter and this decreases with age.
Collapse
Affiliation(s)
- Joaquín Fernández
- From the Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain (Fernández, Rodríguez-Vallejo, Burguera, Rocha-de-Lossada), the Department of Ophthalmology, Hospital Virgen de las Nieves, Av. de las Fuerzas Armadas, Granada, Spain (Rocha-de-Lossada), the Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero), and the Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain (Piñero)
| | | | | | | | | |
Collapse
|
12
|
Near visual acuity and patient-reported outcomes in presbyopic patients after bilateral multifocal aspheric laser in situ keratomileusis excimer laser surgery. J Cataract Refract Surg 2021; 46:944-952. [PMID: 32773548 DOI: 10.1097/j.jcrs.0000000000000198] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine improvement of near visual acuity by bilateral multifocal aspheric laser in situ keratomileusis (LASIK) treatments in presbyopic patients. SETTING Goethe-University, Frankfurt, Germany. DESIGN Prospective, nonrandomized trial. METHODS Thirty presbyopic patients underwent LASIK treatment with a multifocal aspheric ablation profile using an excimer laser (PresbyMAX). The first 15 patients received a multifocal aspheric ablation profile combined with micromonovision. For the consecutive 15 patients, less depth of focus was included on the distance eye (hybrid). Outcome parameters were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuities, uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity (DCNVA); manifest refraction spherical equivalent; subjective quality of vision; and spectacle independence. RESULTS The data of 29 patients were analyzed and showed that binocular CDVA changed from -0.16 ± 0.10 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.20 logMAR UDVA and -0.06 ± 0.14 logMAR CDVA (P = .000, P = .001) 1 year postoperatively. Near visual acuity improved from 0.47 ± 0.13 logMAR (DCNVA) and 0.48 ± 0.26 logMAR (UNVA) to 0.19 ± 0.19 logMAR (DCNVA, P < .001) and 0.05 ± 0.15 logMAR (UNVA, P < .001). The hybrid and the μ-monovision group did not differ statistically except for a better DCNVA in the µ-monovision patients (0.21 ± 0.15 logMAR vs 0.34 ± 0.17 logMAR, P = .034). Of the hybrid and µ-monovision patients, 21 (72%) and 12 (41%) had a binocular CDVA and UDVA of 20/20 or better, 8 patients (28%) lost 1 line, 3 (10%) lost 2 lines, 4 (14%) lost 3 lines, and 2 (7%) lost 4 lines of CDVA. CONCLUSIONS The PresbyMAX laser seemed to satisfy most of the patients, although they experienced a loss of CDVA. The gain of near visual acuity and therefore reported less need of spectacles seemed to compensate for this loss.
Collapse
|
13
|
Shetty R, Brar S, Sharma M, Dadachanji Z, Lalgudi VG. PresbyLASIK: A review of PresbyMAX, Supracor, and laser blended vision: Principles, planning, and outcomes. Indian J Ophthalmol 2021; 68:2723-2731. [PMID: 33229648 PMCID: PMC7857007 DOI: 10.4103/ijo.ijo_32_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PresbyLASIK is one of the most commonly used modalities of surgical correction in presbyopes with no cataract. Unlike monovision procedures, both the eyes are adjusted for near and distance, providing a good stereopsis. This works by creating a corneal multifocality and increasing the depth of focus. Most techniques of presbyLASIK currently employ hybrid methods, i.e., a component of monovision added on to a multifocal corneal ablation. Choosing an appropriate proportion of these two components according to the patients' requirements and meticulous patient selection are key to obtaining desirable outcomes. Being corneal-based procedures, presbyLASIK has shown to be reversible. Thorough updated knowledge of the different presbyLASIK procedures, their principles and outcomes based on previous studies is required before a refractive surgeon plans to start providing presbyLASIK services. We performed a comprehensive search on PubMed with the keywords "Presbyopia surgery," "PresbyLASIK" "PresbyMAX," "Supracor," and "Custom-Q." In this review article, we have explained the principles of the various presbyLASIK procedures, appropriate patient selection and planning on the devices with examples, and summarized the previously published outcomes of these techniques.
Collapse
Affiliation(s)
- Rohit Shetty
- Cornea and Refractive Surgery Department, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sheetal Brar
- Consultant, Nethradhama Superspecialty Eye Hospital, Bengaluru, Karnataka, India
| | - Mohita Sharma
- Chairperson, Tirupati Eye Centre, Noida, Uttar Pradesh, India
| | - Zelda Dadachanji
- Cornea and Refractive Surgery Department, Narayana Nethralaya, Bengaluru, Karnataka, India
| | | |
Collapse
|
14
|
Hervella L, Villegas EA, Robles C, Artal P. Spherical Aberration Customization to Extend the Depth of Focus With a Clinical Adaptive Optics Visual Simulator. J Refract Surg 2021; 36:223-229. [PMID: 32267952 DOI: 10.3928/1081597x-20200212-02] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/10/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the use of the VAO adaptive optics visual simulator (Voptica SL, Murcia, Spain) for customization of spherical aberration to increase depth of focus. METHODS Through-focus visual acuity with both high- and low-contrast letters from +1.00 to -3.00 diopters (D) was measured in 17 dilated eyes with three different induced amounts of spherical aberration for a 4.5-mm pupil diameter: control (0 µm), -0.15 µm, and -0.30 µm. RESULTS The defocus curves followed the same behavior with both values of contrast, but the visual acuity was 0.2 logMAR lower with low contrast. The mean values of high-contrast logMAR visual acuity at far, intermediate (67 cm), and near (40 cm) were -0.10, 0.11, and 0.37 for control, 0.04, 0.00, and 0.15 for -0.15 µm, and 0.23, 0.00, and 0.06 for -0.30 µm conditions. The 95% confidence interval ranged from ±0.14 to ±0.45 logMAR and the middle 50% of the distribution was approximately 0.2 logMAR. CONCLUSIONS Negative values of spherical aberration extend the depth of focus in different ways depending on each patient. The VAO is a new instrument that allows the visual customization of spherical aberration to enhance depth of focus. [J Refract Surg. 2020;36(4):223-229.].
Collapse
|
15
|
Rahmania N, Salah I, Rampat R, Gatinel D. Clinical Effectiveness of Laser-Induced Increased Depth of Field for the Simultaneous Correction of Hyperopia and Presbyopia. J Refract Surg 2021; 37:16-24. [DOI: 10.3928/1081597x-20201013-03] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/08/2020] [Indexed: 01/19/2023]
|
16
|
Fu D, Zhao J, Zeng L, Zhou X. One Year Outcome and Satisfaction of Presbyopia Correction Using the PresbyMAX® Monocular Ablation Profile. Front Med (Lausanne) 2020; 7:589275. [PMID: 33330548 PMCID: PMC7732614 DOI: 10.3389/fmed.2020.589275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/04/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose: To explore the safety, efficacy, and satisfaction of the PresbyMAX monocular mode for the correction of presbyopia. Methods: Prospective study. Twenty-two patients (mean age 50.6 ± 6.2 years, 11 myopia patients and 11 hyperopia patients) were enrolled. The dominant eye was fully corrected for distance vision; the non-dominant eye was corrected using central PresbyMAX monocular mode. Binocular uncorrected distance visual acuity (BUDVA), near visual acuity (BUNVA), intermediate visual acuity (BUIVA), corrected distance visual acuity (CDVA), and mean spherical equivalent (SE) were tested at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively. Questionnaire was performed preoperatively, 1 month, 3 months, and 1 year after surgery. Results: At the final visit, the mean safety index was 1.03 ± 0.14. There were 85.7% eyes with the same or better CDVA than the preoperative value, and 17.1% and 2.9% eyes gained 1 line and 2 lines of CDVA, respectively. All treated eyes achieved 20/25 or better BUDVA, and 95.5% achieved 20/32 or better BUNVA, which improved significantly compared with preoperative values (P < 0.001). BUDVA maintained stability from 1 month postoperatively, BUNVA and BUIVA kept stable since 1 week after surgery. Overall satisfaction was 95.5% (21/22) at 3 months visit, and 100% at the last visit. No differences in terms of visual acuity and satisfaction were found between the myopia and hyperopia groups. Conclusion: The PresbyMAX monocular ablation profile was safe and effective in treating presbyopia, with great satisfaction achieved at postoperative 1 year.
Collapse
Affiliation(s)
- Dan Fu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Li Zeng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|
17
|
Siedlecki J, Schmelter V, Schworm B, Mayer WJ, Priglinger SG, Dirisamer M, Luft N. Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction. Acta Ophthalmol 2020; 98:e907-e913. [PMID: 32212414 DOI: 10.1111/aos.14420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/04/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE To analyse in depth the associations between objectively measured corneal higher-order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire. METHODS This cross-sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients' subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances. RESULTS A total of 394 eyes of 197 patients with a mean age of 32.4 ± 7.7 years and a mean postoperative follow-up of 24.3 ± 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 ± 0.131 µm), coma (0.142 ± 0.179 µm), trefoil (0.018 ± 0.067 µm) as well as in total HOAs (0.191 ± 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R2 values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164). CONCLUSIONS Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient-reported QOV or specific long-term visual symptoms.
Collapse
Affiliation(s)
- Jakob Siedlecki
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Valerie Schmelter
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
| | - Benedikt Schworm
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Wolfgang J. Mayer
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
| | - Siegfried G. Priglinger
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Martin Dirisamer
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Nikolaus Luft
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| |
Collapse
|
18
|
Ang M, Gatinel D, Reinstein DZ, Mertens E, Alió Del Barrio JL, Alió JL. Refractive surgery beyond 2020. Eye (Lond) 2020; 35:362-382. [PMID: 32709958 DOI: 10.1038/s41433-020-1096-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023] Open
Abstract
Refractive surgery refers to any procedure that corrects or minimizes refractive errors. Today, refractive surgery has evolved beyond the traditional laser refractive surgery, embodied by the popular laser in situ keratomileusis or 'LASIK'. New keratorefractive techniques such as small incision lenticule extraction (SMILE) avoids corneal flap creation and uses a single laser device, while advances in surface ablation techniques have seen a resurgence in its popularity. Presbyopic treatment options have also expanded to include new ablation profiles, intracorneal implants, and phakic intraocular implants. With the improved safety and efficacy of refractive lens exchange, a wider variety of intraocular lens implants with advanced optics provide more options for refractive correction in carefully selected patients. In this review, we also discuss possible developments in refractive surgery beyond 2020, such as preoperative evaluation of refractive patients using machine learning and artificial intelligence, potential use of stromal lenticules harvested from SMILE for presbyopic treatments, and various advances in intraocular lens implants that may provide a closer to 'physiological correction' of refractive errors.
Collapse
Affiliation(s)
- Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore.
| | | | - Dan Z Reinstein
- London Vision Clinic, London, UK.,Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Sorbonne Université, Paris, France.,Biomedical Science Research Institute, Ulster University, Belfast, UK
| | - Erik Mertens
- Medipolis-Antwerp Private Clinic, Antwerp, Belgium
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| | - Jorge L Alió
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| |
Collapse
|
19
|
Fu D, Zhao J, Zhou XT. Objective optical quality and visual outcomes after the PresbyMAX monocular ablation profile. Int J Ophthalmol 2020; 13:1060-1065. [PMID: 32685392 DOI: 10.18240/ijo.2020.07.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To assess objective visual quality after presbyopia correction using the PresbyMAX monocular mode. METHODS This prospective, nonrandomized study included 28 eyes from 18 patients (mean age 50.4±5.6y) who underwent presbyopia correction with the PresbyMAX monocular mode. Monocular and binocular visual acuities were evaluated preoperatively, 1d, 1wk, 1, 3mo, and 1y after surgery. Optical quality was analyzed by Hartmann-Shack wavefront aberration supported cornea ablation. Modulation transfer function (MTF) cutoff frequency, Strehl ratio, and objective scattering index (OSI) were analyzed using an optical quality analysis system. RESULTS One year after surgery, 100% and 94.4% of patients achieved binocular uncorrected distance and near visual acuity of 20/25, respectively. At the last visit Spherical aberration and total higher aberration were higher than the corresponding preoperative levels (P<0.001); however, no significant difference was found in MTF, OSI, or Strehl ratio. Transient decreases in OSI and MTF mainly occurred in the nondominant eyes. There was no significant difference in optical quality between the dominant and nondominant eyes, except for spherical aberration and horizontal coma (P<0.05). CONCLUSION The PresbyMAX monocular mode is safe and effective for presbyopia correction. It has little effect on optical quality, though short-term degraded optical quality occurred mainly in the bi-aspheric ablated eyes.
Collapse
Affiliation(s)
- Dan Fu
- Eye and ENT Hospital of Fudan University, Shanghai 200030, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai 200030, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200030, China
| | - Jing Zhao
- Eye and ENT Hospital of Fudan University, Shanghai 200030, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai 200030, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200030, China
| | - Xing-Tao Zhou
- Eye and ENT Hospital of Fudan University, Shanghai 200030, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai 200030, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200030, China
| |
Collapse
|
20
|
Liu F, Zhang T, Liu Q. One year results of presbyLASIK using hybrid bi-aspheric micro-monovision ablation profile in correction of presbyopia and myopic astigmatism. Int J Ophthalmol 2020; 13:271-277. [PMID: 32090037 DOI: 10.18240/ijo.2020.02.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze one year clinical outcomes and subjective rating of hybrid bi-aspheric multifocal central presbyLASIK with micro-monovision for correction of presbyopia and myopic astigmatism. METHODS Seventy-four eyes of 37 patients consecutively treated with presbyLASIK were assessed. The mean age of the patients was 43.8±3.0y with a mean spherical equivalent refraction of -5.21±1.87 diopters (D) and mean astigmatism of -0.82±0.64 D. Visual acuity, manifest refraction, contrast sensitivity, aberrometry and patients' subjective rating were evaluated pre- and postoperatively. RESULTS At 1y postoperatively (68 eyes of 34 patients), the mean spherical equivalent (SE) refraction in distance eyes was 0.06±0.05 D, whereas the achieved SE in near eyes was -0.83±0.05 D. Ninety-nine percent of eyes were within ±0.50 D of target correction of SE. The binocular mean uncorrected distance visual acuity (UDVA) was 0.00±0.18 logMAR (20/20). Sixty-four percent of patients achieved 0.0 logMAR (20/20) or better of UDVA and 0.1 logRAD or better of UNVA as well. There was a binocularly loss of one line CDVA after surgery for only one patient (3%, 1/34) and no patient lost 2 lines. The changes in binocular contrast sensitivity (CS) in all test conditions were not significant at any frequency after surgery. The changes of entire eye total higher order aberrations (tHOA) and spherical aberrations (SA) significantly higher in near eyes than in distance eyes. The overall satisfaction score for surgery was 93±8. CONCLUSION The hybrid bi-aspheric multifocal central presbyLASIK with micro-monovision appears to be an efficacious option for myopic presbyopes. One year postoperative outcomes in a relatively young presbyopia population indicate improvements in both far and near vision with high satisfaction.
Collapse
Affiliation(s)
- Fang Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ting Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Quan Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| |
Collapse
|
21
|
Luger MHA, McAlinden C, Buckhurst PJ, Wolffsohn JS, Verma S, Arba-Mosquera S. Long-term Outcomes After LASIK Using a Hybrid Bi-aspheric Micro-monovision Ablation Profile for Presbyopia Correction. J Refract Surg 2020; 36:89-96. [PMID: 32032429 DOI: 10.3928/1081597x-20200102-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/02/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate visual outcomes 6 years after hybrid bi-aspheric multifocal central laser in situ keratomileusis for presbyopia correction (PresbyLASIK) treatments. METHODS Thirty-eight eyes of 19 patients consecutively treated with central PresbyLASIK were assessed. The mean age of the patients was 51 ± 3 years at the time of treatment with a mean spherical equivalent refraction of -0.57 ± 1.98 diopters (D) and mean astigmatism of 0.58 ± 0.57 D. Monocular corrected distance visual acuity (CDVA), corrected near visual acuity (CNVA), and distance-corrected near visual acuity (DCNVA), uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), and uncorrected near visual acuity (UNVA) were assessed preoperatively and postoperatively for the dominant eye, non-dominant eye, and binocularly. Subjective quality of vision and near vision were assessed using the 10-item, Rasch-scaled, Quality of Vision (QoV) Questionnaire and Near Activity Visual Questionnaire (NAVQ), respectively. RESULTS At 6 years postoperatively, mean binocular UDVA was 20/18 ± 4 and mean binocular UNVA and UIVA were 0.11 ± 0.13 and -0.08 ± 0.08 logRAD, respectively. Spherical equivalent showed a slow hyperopic drift of +0.10 D per year with refractive astigmatism stable from 6 weeks postoperatively. Defocus curves showed an improvement of 0.4 Snellen lines at best focus from 1 to 6 years of follow-up, reaching preoperative levels. Compared to the preoperative status, the corneal and ocular spherical aberrations (at a 6-mm diameter) decreased and were stable from 3 months of follow-up. Questionnaires revealed a postoperative unaided QoV score comparable to preoperative scores and with an improved postoperative unaided NAVQ score compared to preoperative scores with best correction. CONCLUSIONS Presbyopic treatment using a hybrid bi-aspheric micro-monovision ablation profile is safe and efficacious even after 6 years postoperatively. The postoperative outcomes indicate improvements in binocular vision at far, intermediate, and near distances. An 8% re-treatment rate should be considered to increase satisfaction levels, including a 3% reversal rate. [J Refract Surg. 2020;36(2):89-96.].
Collapse
|
22
|
Taneri S, Kiessler S, Rost A, Verma S, Arba-Mosquera S, Dick HB. Varifocal Versus Monofocal LASIK in Presbyopic Hyperopic Eyes. J Refract Surg 2019; 35:459-466. [PMID: 31298726 DOI: 10.3928/1081597x-20190528-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare varifocal (SupraCor; Technolas Perfect Vision GmbH, Munich, Germany) to monofocal (Zyoptix TissueSaving; Bausch & Lomb, Rochester, NY) LASIK in patients with hyperopic presbyopia. METHODS In this prospective, non-randomized, comparative case series, consecutive patients with hyperopia, presbyopia, and emmetropia as target refraction were bilaterally treated with varifocal (8 patients) or monofocal (7 patients) LASIK. The study was designed for 35 patients, but was terminated early after interim analysis. Outcomes (preoperative and 1 day, 1 week, 1 month, and 3 months postoperative) were: monocular and binocular uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), low-contrast UDVA and CDVA, efficacy, and safety. RESULTS Preoperative data were similar in both groups. Monocular and binocular UNVA were not significantly different between both groups at any follow-up visit. At 3 months, mean monocular UNVA was 0.40 logMAR in both groups. Monocular DCNVA and binocular CDVA were not significantly different between groups. Monocular mean CDVA was 0.00 ± 0.06 logMAR after varifocal LASIK and -0.06 ± 0.04 logMAR after monofocal LASIK. The efficacy index was 0.9 after vari-focal LASIK and 0.88 after monofocal LASIK (not significant). The safety index was 1.08 after varifocal LASIK and 1.125 after monofocal LASIK (not significant). CONCLUSIONS With emmetropia as target refraction, varifocal ablations yielded no additional benefit compared to monofocal ablations in hyperopic presbyopic LASIK. The authors speculate that epithelial remodeling masks the impact of a varifocal ablation pattern and that a myopic postoperative refraction (modified monovision) may be necessary to further improve near and intermediate vision. These results demonstrate the value of a control group in studies evaluating presbyopia corrections. [J Refract Surg. 2019;35(7):459-466.].
Collapse
|
23
|
Schmelter V, Dirisamer M, Siedlecki J, Shajari M, Kreutzer TC, Mayer WJ, Priglinger SG, Luft N. Determinants of subjective patient-reported quality of vision after small-incision lenticule extraction. J Cataract Refract Surg 2019; 45:1575-1583. [PMID: 31585852 DOI: 10.1016/j.jcrs.2019.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/22/2019] [Accepted: 06/17/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To characterize patient-reported long-term quality of vision (QoV) after small-incision lenticule extraction (SMILE), and to identify potential clinical parameters that might predispose to experiencing deteriorated visual quality. SETTING University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany. DESIGN Prospective cross-sectional study. METHODS For the assessment and scoring of visual symptoms, the Quality of Vision questionnaire was employed, which constitutes a clinically validated, linear-scaled 30-item instrument providing a QoV score on three scales (symptom frequency, severity, and bothersome). Subgroup analyses were performed for patient subgroups stratified by baseline characteristics (eg, age) and treatment parameters (eg, surgical refractive correction) as well as refractive outcomes (eg, residual refraction) and visual outcomes (eg, uncorrected distance visual acuity [UDVA]). RESULTS The study comprised 394 eyes of 197 patients (117 women [59.4%], 80 men [40.6%]) were included with a mean postoperative follow-up of 24.4 months ± 14.1 (SD). The QoV scores for symptom frequency, severity, and bothersome were 34.63 ± 13.69, 29.60 ± 12.38, and 24.56 ± 16.00, respectively. Patients with a preoperative binocular corrected distance visual acuity (CDVA) of 20/12.5 or better, patients who lost 1 or more lines of UDVA as compared with preoperative CDVA, patients older than the age of 40, and patients with inadvertent anisometropia more than 0.375 diopters reported worse QoV scores. CONCLUSION The relationship between objective clinical parameters and patient-reported subjective QoV after SMILE seems complex. Defined prognostic factors that convey a higher risk for experiencing visual disturbances were identifiable and should be discussed with patients seeking SMILE treatment during preoperative counseling.
Collapse
Affiliation(s)
- Valerie Schmelter
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Martin Dirisamer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany; SMILE Eyes Clinic, Linz, Austria
| | - Jakob Siedlecki
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany; SMILE Eyes Clinic, Linz, Austria
| | - Mehdi Shajari
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas C Kreutzer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfgang J Mayer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Siegfried G Priglinger
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany; SMILE Eyes Clinic, Linz, Austria
| | - Nikolaus Luft
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany; SMILE Eyes Clinic, Linz, Austria.
| |
Collapse
|
24
|
Chiam NP, Mehta JS. Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction: A Review. Asia Pac J Ophthalmol (Phila) 2019; 8:377-384. [PMID: 31478935 PMCID: PMC6784778 DOI: 10.1097/apo.0000000000000258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE) are popular refractive surgeries. The objective refractive outcomes of LASIK and SMILE have been studied extensively; both procedures have comparable safety, efficacy, and predictability. However, owing to various psychosocial factors, refractive patients may report dissatisfaction despite good postoperative vision. Hence the importance of studies on subjective patient-reported outcomes. This review discusses the role of psychometric-technique-based validated questionnaires when evaluating subjective outcomes. It also summarizes the literature on patient-reported outcomes for LASIK and SMILE. DESIGN A literature search was performed on PubMed database to identify studies that have assessed patient-reported outcomes for LASIK and SMILE. RESULTS Several studies have looked into patient-reported outcome measures for LASIK, but the number of equivalent studies for SMILE is limited. Questionnaires (validated and non-validated) are used to evaluate patient-reported outcomes. Validated questionnaires are designed based on psychometric techniques, such as Classic Test Theory, Item Response Theory, and Rasch analysis. The Quality of Life Impact of Refractive Correction (QIRC) questionnaire, a validated questionnaire administered to both LASIK and SMILE patients, suggests that both groups have comparable vision-related quality of life in the first few months postoperatively; but SMILE might confer a slight advantage in the later postoperative period (postoperative month 6). CONCLUSIONS Future LASIK-SMILE comparative studies utilizing standardized validated questionnaires for patient-reported outcome measures with longer follow-up durations would be a welcome contribution to this important aspect of refractive surgery.
Collapse
Affiliation(s)
| | - Jodhbir S. Mehta
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
| |
Collapse
|
25
|
Romero M, Castillo A, Carmona D, Palomino C. Visual quality after presbyopia correction with excimer laser ablation using micromonovision and modulation of spherical aberration. J Cataract Refract Surg 2019; 45:457-464. [DOI: 10.1016/j.jcrs.2018.10.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/24/2018] [Accepted: 10/29/2018] [Indexed: 01/19/2023]
|
26
|
Villanueva A, Vargas V, Mas D, Torky M, Alió JL. Long-term corneal multifocal stability following a presbyLASIK technique analysed by a light propagation algorithm. Clin Exp Optom 2019; 102:496-500. [PMID: 30866063 DOI: 10.1111/cxo.12883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 01/16/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is a lack of scientific evidence on long-term follow-up of the outcomes of the presbyLASIK techniques. This study aimed to objectively evaluate corneal stability three years following excimer laser central presbyLASIK. METHODS This is a longitudinal, retrospective, observation of a consecutive series of cases comprising 24 eyes which had been treated by central myopic or hyperopic Presbymax central presbyLASIK. Eyes treated with the same version of presbyLASIK software were included and followed by corneal topography at three months, one and three years after surgery. Based on the corneal topography data, customised software - based on a light propagation algorithm and developed using Matlab software - was used to analyse the simulated behaviour of light through the ocular media. The range of objective corneal depth of focus was also measured. RESULTS Results were assessed separately for myopes and hyperopes at pupillary diameters of 3.0 and 6.0 mm. The results showed corneal multifocality outcomes to remain constant (p > 0.05) throughout the three-year follow-up period. CONCLUSION The use of light propagation analysis of the multifocal anterior corneal surface following a Presbymax central presbyLASIK procedure demonstrated stable outcomes over a three-year follow-up period.
Collapse
Affiliation(s)
- Asier Villanueva
- Department of Optics and Optometry, University of Alicante, Alicante, Spain
| | | | - David Mas
- Department of Optics and Optometry, University of Alicante, Alicante, Spain
| | - Magda Torky
- Department of R&D, Vissum Corporation, Alicante, Spain
| | - Jorge L Alió
- Department of R&D, Vissum Corporation, Alicante, Spain.,Department of Ophthalmology, University Miguel Hernández, Alicante, Spain
| |
Collapse
|
27
|
Khodzhabekyan NV, Khandzhyan AT, Tarutta EP. A symmetric hypocorrection of myopia by FemtoLASIK in patients with presbyopia. ACTA ACUST UNITED AC 2018. [DOI: 10.21516/2072-0076-2018-11-4-43-48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: to evaluate the results of symmetric binocular hypocorrection of myopia with FemtoLasik surgery in patients with presbyopia of various age groups.Material and methods. 33 patients (66 eyes) with myopic refraction, aged 36 to 50, were operated by FemtoLasik. The intended Femto Flap thickness was 100 μm. The patients were divided into three groups depending on age; group 1 included 16 patients (32 eyes) aged 39–44, group 2 had 12 patients (24 eyes) aged 45–50, and group 3 (controls) was composed of 5 patients (10 eyes) of pre-presbyopic age (36–38 years).Results. The symmetric binocular hypocorrection proved efficient in 35 % of cases in the group 1 and 50 % of cases in group 2. In the control group the intended and obtained values coincided in all 100 % of cases.Conclusion. A possible cause of the discrepancy between the intended and the obtained hypocorrection effect may be a reduced corneal hydration of patients older than 39 years.
Collapse
|
28
|
Vukich JA, Durrie DS, Pepose JS, Thompson V, van de Pol C, Lin L. Evaluation of the small-aperture intracorneal inlay: Three-year results from the cohort of the U.S. Food and Drug Administration clinical trial. J Cataract Refract Surg 2018; 44:541-556. [DOI: 10.1016/j.jcrs.2018.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 10/16/2022]
|
29
|
Balgos MJTD, Vargas V, Alió JL. Correction of presbyopia: An integrated update for the practical surgeon. Taiwan J Ophthalmol 2018; 8:121-140. [PMID: 30294526 PMCID: PMC6169332 DOI: 10.4103/tjo.tjo_53_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Presbyopia results from loss or insufficiency of the eye's accommodative ability, and clinically manifests as the inability to focus near objects on the retina. It is one of the most common causes of visual impairment worldwide especially in adults of productive or working age. Various means of compensating for the loss of accommodative ability have been devised from optical tools such as spectacles and contact lenses, to topical medications and to surgical procedures. A comprehensive search on journal articles about topical and surgical correction of presbyopia was undertaken. The various techniques for presbyopia correction, as enumerated in these articles, are discussed in this paper with the addition of our personal experience and perspective on the future of these techniques.
Collapse
Affiliation(s)
| | | | - Jorge L Alió
- VISSUM Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Spain
| |
Collapse
|
30
|
Patient-reported Outcomes for Assessment of Quality of Life in Refractive Error: A Systematic Review. Optom Vis Sci 2017; 94:1102-1119. [PMID: 29095758 DOI: 10.1097/opx.0000000000001143] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This review has identified the best existing patient-reported outcome (PRO) instruments in refractive error. The article highlights the limitations of the existing instruments and discusses the way forward. PURPOSE A systematic review was conducted to identify the types of PROs used in refractive error, to determine the quality of the existing PRO instruments in terms of their psychometric properties, and to determine the limitations in the content of the existing PRO instruments. METHODS Articles describing a PRO instrument measuring 1 or more domains of quality of life in people with refractive error were identified by electronic searches on the MEDLINE, PubMed, Scopus, Web of Science, and Cochrane databases. The information on content development, psychometric properties, validity, reliability, and responsiveness of those PRO instruments was extracted from the selected articles. The analysis was done based on a comprehensive set of assessment criteria. RESULTS One hundred forty-eight articles describing 47 PRO instruments in refractive error were included in the review. Most of the articles (99 [66.9%]) used refractive error-specific PRO instruments. The PRO instruments comprised 19 refractive, 12 vision but nonrefractive, and 16 generic PRO instruments. Only 17 PRO instruments were validated in refractive error populations; six of them were developed using Rasch analysis. None of the PRO instruments has items across all domains of quality of life. The Quality of Life Impact of Refractive Correction, the Quality of Vision, and the Contact Lens Impact on Quality of Life have comparatively better quality with some limitations, compared with the other PRO instruments. CONCLUSIONS This review describes the PRO instruments and informs the choice of an appropriate measure in refractive error. We identified need of a comprehensive and scientifically robust refractive error-specific PRO instrument. Item banking and computer-adaptive testing system can be the way to provide such an instrument.
Collapse
|
31
|
An Italian Translation and Validation of the near Activity Visual Questionnaire (NAVQ). Eur J Ophthalmol 2017; 27:640-645. [DOI: 10.5301/ejo.5000957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose To validate the Near Activity Vision Questionnaire (NAVQ) in Italian to allow the assessment of presbyopia corrections in Italian-speaking patients. Methods An Italian version of the NAVQ was arranged through several steps: an initial forward translation (from English to Italian), a backward translation (from Italian to English), and finally a consensual version to check against the original NAVQ. This prospective study enrolled native Italian-speaking presbyopic patients with corrected distance visual acuity of 0.20 logMAR or better in each eye and free of ocular anomalies. Six different groups of patients were asked to complete the questionnaire: emerging presbyopic patients, reading spectacle users, multifocal spectacle users, multifocal contact lens (CL) wearers, monovision CL wearers, and monofocal intraocular lens patients. Subjects were asked to answer the questionnaire again 2 weeks after the first completion. Results A total of 207 subjects completed the questionnaire. Data analysis showed good internal consistency (Cronbach α = 0.93) and factorial validity with only one factor explaining 62.0% of the variance. Test-retest reliability was extremely good (ICC = 0.92) as well as discriminatory power of the questionnaire's ability to discriminate between subjects with different forms of presbyopic correction. Conclusions The Italian version of the NAVQ matches the properties of the original English version. It is a valid instrument to evaluate near activity visual quality of presbyopic Italian speakers.
Collapse
|
32
|
Verdoorn C. Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality. Clin Ophthalmol 2017; 11:1727-1734. [PMID: 29033538 PMCID: PMC5614777 DOI: 10.2147/opth.s142075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To compare the visual performance and optical quality after Raindrop Near Vision Inlay implantation or monovision LASIK for the correction of presbyopia. MATERIALS AND METHODS In this retrospective case-series study, patients previously treated in the nondominant eye with monovision LASIK were compared with patients previously implanted with Raindrop Near Vision Inlay. The study enrolled 16 inlay and 15 monovision LASIK patients. Uncorrected near visual acuity, uncorrected distance visual acuity, binocular stereopsis, patient satisfaction, and patient task performance were assessed. RESULTS Postoperatively, the mean spherical equivalent was -0.66 D (0.78 SD) for the inlay group and -1.03 D (0.56 SD) for the monovision LASIK group. Monocularly, at uncorrected near distances, 60% of inlay patients and 47% of monovision LASIK patients achieved ≥20/20. Monocularly, at uncorrected far distances, 75% of inlay patients and 40% of monovision LASIK patients achieved ≥20/32 vision. Binocularly, at near distances, 79% of inlay patients and 53% of monovision LASIK patients obtained ≥20/20 vision. All patients achieved ≥20/20 binocularly for distance. On average, inlay patients obtained 98 seconds of arc and monovision LASIK patients obtained 286 seconds of arc for stereopsis. Most (79%) of the inlay patients and 66% of monovision LASIK patients were satisfied with their near vision, while 86% of inlay patients and 67% of monovision LASIK patients were satisfied with their distance vision. CONCLUSION Patients receiving corneal inlays demonstrated better near and distance visual acuities, binocular stereopsis, task performance, and satisfaction, when compared to patients treated with monovision LASIK.
Collapse
|
33
|
Chan TCY, Kwok PSK, Jhanji V, Woo VCP, Ng ALK. Presbyopic Correction Using Monocular Bi-aspheric Ablation Profile (PresbyMAX) in Hyperopic Eyes: 1-Year Outcomes. J Refract Surg 2017; 33:37-43. [PMID: 28068445 DOI: 10.3928/1081597x-20161006-03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/29/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To present the 1-year outcomes of combining monocular bi-aspheric ablation profile and contralateral monofocal LASIK in hyperopic patients with presbyopia. METHODS In this retrospective case series, 36 consecutive patients (72 eyes) who underwent simultaneous bi-aspheric ablation (PresbyMAX: SCHWIND Eye-Tech-Solutions GmbH and Co KG, Kleinostheim, Germany) in the non-dominant eye and monofocal regular LASIK in the dominant eye for correction of hyperopia and presbyopia were reviewed for 1 year. Binocular uncorrected distance (UDVA), near (UNVA), corrected distance (CDVA), and distance corrected near (DCNVA) visual acuity and manifest refraction were analyzed postoperatively. RESULTS At 1 year, the mean binocular UDVA improved significantly from 0.26 ± 0.25 to 0.039 ± 0.088 logMAR (P < .001). Binocular UNVA also improved from 0.73 ± 0.30 to 0.10 ± 0.22 logRAD (P < .001). Eighty-seven percent of patients achieved UDVA of 20/25 or better and 90% had UNVA of J3 or better. Simultaneous binocular distance and near vision of 20/25 and J2 or better was achieved in 70%. Only 17% of patients had a binocular DCNVA of J2 or better. No patient suffered from a loss of 2 lines of CDVA. Refractive stability was achieved for both eyes from 1 month postoperatively. The re-treatment rate was 14% for improvement of near vision within 6 months to 1 year. CONCLUSIONS Presbyopic correction using monocular PresbyMAX combined with monofocal regular LASIK in the fellow eye is safe and acceptable in hyperopic patients. [J Refract Surg. 2017;33(1):37-43.].
Collapse
|
34
|
Courtin R, Saad A, Grise-Dulac A, Guilbert E, Gatinel D. Changes to Corneal Aberrations and Vision After Monovision in Patients With Hyperopia After Using a Customized Aspheric Ablation Profile to Increase Corneal Asphericity (Q-factor). J Refract Surg 2017; 32:734-741. [PMID: 27824376 DOI: 10.3928/1081597x-20160810-01] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/18/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the visual outcomes and fourth-order Zernike spherical aberrations induced with a customized change in corneal asphericity (ΔQ) correction of presbyopia combined with monovision for hyperopic patients. METHODS Consecutive hyperopic patients who underwent presbyopic LASIK between September 2013 and July 2014 were included. For the non-dominant eyes, the aspheric ablation profile associated with a myopic refraction was planned using the Custom-Q nomogram (Alcon Laboratories, Inc., Fort Worth, TX). Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), spherical equivalent refraction, ΔQ, and change in corneal spherical aberration coefficient (ΔC40) were analyzed. Postoperative data were collected at 1, 3, and 6 months. RESULTS Sixty-five patients were included. The mean age was 56.5 ± 5.7 years (range: 47 to 70 years). At the 6-month follow-up, the spherical equivalent refraction for non-dominant and dominant eyes was -1.07 ± 0.74 and 0.32 ± 0.55 diopters (D), respectively. The mean binocular UDVA was 0.01 ± 0.04 logMAR (range: -0.12 to 0.30 logMAR); 91% of patients achieved 20/20 or better binocular UDVA and 83% of patients had Jaeger 3 (Parinaud 4) or better binocular UNVA. The ΔQ for non-dominant and dominant eyes was -0.61 ± 0.15 and -0.33 ± 0.25, respectively, for a 6-mm pupil diameter and was significantly higher for non-dominant eyes (P < .0001). The achieved ΔC40 was -0.49 ± 0.23 µm for non-dominant eyes (for a theoretical ideal value of -0.40 µm) and -0.30 ± 0.18 µm for dominant eyes. For non-dominant eyes, the attempted ΔQ (-0.60) was close to the achieved value (-0.61 ± 0.15). CONCLUSIONS For hyperopic patients, combining the customized corneal aspheric ablation profile with monovision is safe, effective, and reproducible, inducing intended changes in corneal spherical aberrations. [J Refract Surg. 2016;32(11):734-741.].
Collapse
|
35
|
Kandel H, Khadka J, Lundström M, Goggin M, Pesudovs K. Questionnaires for Measuring Refractive Surgery Outcomes. J Refract Surg 2017; 33:416-424. [DOI: 10.3928/1081597x-20170310-01] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/18/2017] [Indexed: 11/20/2022]
|
36
|
Vargas-Fragoso V, Alió JL. Corneal compensation of presbyopia: PresbyLASIK: an updated review. EYE AND VISION 2017; 4:11. [PMID: 28413804 PMCID: PMC5390462 DOI: 10.1186/s40662-017-0075-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022]
Abstract
Abstract The main purpose of this review is to compare and analyze the results of the main PresbyLASIK approaches; central and peripheral. Summary A comprehensive research was conducted in PUBMED using keywords like “presbyopia correction”, “PresbyLASIK”, “Corneal multifocality”, “Laser blended vision”. We reviewed the PresbyLASIK technique, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA), and compared the differences between the techniques.
Collapse
Affiliation(s)
| | - Jorge L Alió
- Vissum Corporation, Edificio Vissum, Calle Cabañal 1, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Carretera Alicante-Valencia km 8.7, Alicante, Spain
| |
Collapse
|
37
|
Abstract
PURPOSE To evaluate the outcomes of myopic small incision lenticule extraction (SMILE) monovision in presbyopic patients. METHODS This study included 49 presbyopic patients older than 45 years seeking surgical correction of myopia or myopic astigmatism who underwent bilateral SMILE with planned monovision in the SMILE Eyes Clinic Linz, Austria. Target refraction was plano for dominant (distance) eyes and ranged between -1.25 and -0.50 D for nondominant (near) eyes. Best-corrected distance visual acuity, uncorrected distance visual acuity (UDVA), uncorrected near visual acuity, as well as spectacle dependence were assessed after a mean postoperative period of 7.2 ± 4.8 months. RESULTS Mean age was 49 ± 3 years and female to male ratio was 30:19. Distance eyes achieved a spherical equivalent correction of ±0.50 D from target refraction in 80% of patients and 96% were within ±1.0 D. Binocular UDVA of 20/20 or better was achieved by 90% of patients and all patients achieved 20/25 or better. The proportion of patients with a binocular UDVA of 20/20 or better who could read J2 or better amounted to 84%. Complete spectacle independence was achieved by 84% of patients and independence from reading glasses was achieved in 92% of cases. No patient requested refractive enhancement or monovision reversal. CONCLUSIONS This first evaluation of SMILE monovision endorses the approach as a safe and effective option for the correction of presbyopia in myopic patients seeking refractive surgery.
Collapse
|
38
|
Jacob S, Kumar DA, Agarwal A, Agarwal A, Aravind R, Saijimol AI. Preliminary Evidence of Successful Near Vision Enhancement With a New Technique: PrEsbyopic Allogenic Refractive Lenticule (PEARL) Corneal Inlay Using a SMILE Lenticule. J Refract Surg 2017; 33:224-229. [DOI: 10.3928/1081597x-20170111-03] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/03/2017] [Indexed: 11/20/2022]
|
39
|
Abstract
PURPOSE The objective of this study was to review the advances in the field of refractive surgery as reported in the peer-reviewed literature during the previous year. DESIGN A literature review. METHODS In this review, we highlight the most pertinent articles in the field from June 2014 to the end of July 2015. RESULTS This past year has seen a growing body of research on small-incision lenticule extraction, presbyopic inlays, and phakic intraocular lenses, as more clinicians are adopting these techniques into their armamentarium. CONCLUSIONS Laser-assisted in situ keratomileusis and photorefractive keratectomy continue to dominate the keratorefractive literature, as they remain the most frequently performed refractive surgeries.
Collapse
Affiliation(s)
- Angelique Pillar
- From the Department of Refractive Surgery, Cole Eye Institute, Cleveland Clinic, Cleveland, OH
| | | |
Collapse
|
40
|
Multifocal Corneal Ablation (Supracor) in Hyperopic Presbyopia: 1-Year Results in a Cross-Sectional Study. Eur J Ophthalmol 2016; 27:438-442. [DOI: 10.5301/ejo.5000871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2016] [Indexed: 11/20/2022]
Abstract
Purpose To evaluate the efficacy and safety of the multifocal excimer laser corneal ablation profile (the Supracor procedure) in hyperopic presbyopia 1 year after laser treatment. Methods This prospective, consecutive, one-center, cross-sectional study included 20 patients with hyperopic presbyopia 1 year after treatment with the Supracor procedure. The main outcome measures were monocular uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA), photopic contrast sensitivity (Pelli-Robson charts), patient satisfaction, and functioning at 12 months. Results Thirty-nine eyes of 20 patients (mean age 59 ± 7.2 years) were treated. Mean UDVA improved from 0.56 ± 0.31 (mean 0.34 logMAR) preoperatively to 0.9 ± 0.15 (mean 0.06 logMAR) 12 months after surgery. Mean UNVA increased from 0.15 ± 0.07 (mean 0.84 logMAR) before surgery to 0.62 ± 0.24 (mean 0.23 logMAR) 12 months after treatment. Four eyes lost 2 lines of corrected distance visual acuity (10.3%). Monocular photopic contrast sensitivity was within age-correlated normal range (Pelli-Robson chart, mean contrast sensitivity 1.83 ± 0.18). A total of 75% of the patients would undergo Supracor again (1 not, 4 perhaps). The most frequently reported side effects were increased glare, reduced distance vision, and fluctuations in vision. Most patients used artificial tears. Conclusions One year after Supracor, UDVA and UNVA improved markedly, photopic contrast sensitivity was in normal age-correlated range, and the majority of patients (75%) was satisfied with the results. Side effects like loss of distance vision, fluctuations of vision, and increased glare have a greater influence on patient satisfaction than the improvement of spectacle-free near vision.
Collapse
|